NPI | 1508496167 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AZ 235607) |
Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: AZ RNP235607) |
Enumeration Date | 2020-01-23 |
Last Update Date | 2023-08-15 |